Prophylactic Antibiotic Pattern in Open Reduction Internal Fixation for Closed Fractures at Dr. Hasan Sadikin General Hospital Bandung in 2013

Deviana Suciani Edwiza; Ike Rostikawati Husen; Widya Arsa

Prophylactic Antibiotic Pattern in Open Reduction Internal Fixation for Closed Fractures at Dr. Hasan Sadikin General Hospital Bandung in 2013

Deviana Suciani Edwiza, Ike Rostikawati Husen, Widya Arsa

Abstract

Background: Surgical site infection remains a serious complication of a surgery. Prophylactic antibiotics should be used in open reduction and internal fixation to prevent surgical site infection. This study aimed to study the pattern of prophylaxis used in internal fixation of closed fractures as this surgery is considered as a high-risk orthopedic procedures.

Methods: This retrospective-descriptive study was performed from August to October 2014. Subject was closed fracture patient who underwent open reduction and internal fixation at Dr. Hasan Sadikin General Hospital Bandung in 2013. Data about characteristics of patients and pattern of the use of prophylactic antibiotics were obtained from patients’ medical record.

Results: Medical records from 76 patients who underwent ORIF were analyzed. Sixty eight patients (68.4%) were given 1 gram cefazolin intravenously as preoperative antibiotic prophylaxis. Timing for administration of antibiotics was 30–60 minute preoperatively in 34 (44.2%) patients. All Patients were given postoperative prophylaxis for 4.09 ± 1.36 days in average. The antibiotic most commonly used was cefazolin in 51 (63%) patients. All patients were prescribed an oral antibiotic at discharge. Cefadroxil was the most common antibiotic prescribed for patients at discharge.

Conclusions: Cefazolin is the most common preoperative prophylactic antibiotic given to patients. All Patients are given postoperative prophylaxis and prescribed an antibiotic at discharge.

Keywords

Antibiotic prophylaxis, closed fractures, internal fixation

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References

Mangram AJ, Horan TC, Pearson ML. Guideline for prevention of surgical site infection: Centers For Disease Prevention and Control; 1999.

Trampuz A, Widmer AF. Infections associated with orthopedic implants. Curr Opin Infect Dis. 2006;19(4):349–56

Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(2):195–283.

Purghel F, Badea R, Ciuvica R, Anastasiu A. The use of antibiotics in traumatology and orthopaedic Surgery. MAEDICA A Journal of Clinical Medicine. 2006;1(3):58–65.

Zimmerli W, Moser C. Pathogenesis and treatment concepts of orthopaedic biofilm infections. Fems Immunol Med Microbiol. 2012;65(2):158–68.

Parwati Ida, Turbawaty Dewi Kartika, Sugianli Adhi Kristianto, editors. Peta bakteri dan kepekaannya terhadap berbagai antibiotika di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung semester 1 tahun 2012. Bandung: Departement of Clinical Pathology Dr. Hasan Sadikin General Hospital; 2012.

Mistry V, Pandya A, Chaudhari J, Sondarva D, Pillai A, Hotchandani S. Use of antimicrobial prophylaxis in clean elective orthopedic surgical procedures and identifying common infective organisms. Int J Med Sci Public Health. 2013;2(4):994–1000.

Lundine KM, Nelson S, Buckley R, Putnis S, Duffy PJ. Adherence to perioperative antibiotic prophylaxis among orthopedic trauma patients. Can J Surg. 2010;53(6):367–72.

Petri WA. Penicillins, cephalosporins, and other β-lactam antibiotics. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman and gilman’s the pharmalogical basis of therapeutics. 11st ed. USA: Mc Graw Hill; 2006. p. 1127–52.

Prokuski L. Prophylactic antibiotics in orthopaedic surgery. J Am Acad Orthop Surg. 2008;16:283–93.

Merrer J, Girou E, Lortat-Jacob A, Montravers P, Lucet JC. Surgical site infection after surgery to repair femoral neck fracture: a French multicenter retrospective study. Infect Control Hosp Epidemiol. 2007;28(10):1169–74.

Jodra VM, Soler LSdlT, Pérez CDA, Requejo CMS, Farrás NP. Excess length of stay attributable to surgical site infection following hip replacement: A Nested Case-Control Study. Infect Control Hosp Epidemiol. 2006;27(12):1299–303.

Claes L, Recknagel S, Ignatius A. Fracture healing under healthy and inflammatory conditions. Nat Rev Rheumatol. 2012;8(3):133–43.

Mathur P, Trikha V, Farooque K, Sharma V, Jain N, Bhardwaj N, et al. Implementation of a short course of prophylactic antibiotic treatment for prevention of postoperative infections in clean orthopaedic surgeries. Indian J Med Res. 2013;137(1):111–6.

Bauer TW, Parvizi J, Kobayashi N, Krebs V. Diagnosis of periprosthetic infection. J Bone Joint Surg Am. 2006;88(4):869–82.